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Cannabis Mobile Apps: a Content Analysis

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JMIR MHEALTH AND UHEALTH Ramo et al Original Paper Cannabis Mobile Apps: A Content Analysis Danielle E Ramo1, PhD; Lucy Popova2, PhD; Rachel Grana2, MPH, PhD; Shirley Zhao1, BA; Kathryn Chavez1, BA 1Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States 2Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco, CA, United States Corresponding Author: Danielle E Ramo, PhD Department of Psychiatry University of California, San Francisco 401 Parnassus Avenue Box TRC 0984 San Francisco, CA, 94143 United States Phone: 1 415 476 7695 Fax: 1 415 476 7053 Email: [email protected] Abstract Background: Mobile technology is pervasive and widely used to obtain information about drugs such as cannabis, especially in a climate of rapidly changing cannabis policy; yet the content of available cannabis apps is largely unknown. Understanding the resources available to those searching for cannabis apps will clarify how this technology is being used to reflect and influence cannabis use behavior. Objective: We investigated the content of 59 cannabis-related mobile apps for Apple and Android devices as of November 26, 2014. Methods: The Apple and Google Play app stores were searched using the terms ªcannabisº and ªmarijuana.º Three trained coders classified the top 20 apps for each term and each store, using a coding guide. Apps were examined for the presence of 20 content codes derived by the researchers. Results: Total apps available for each search term were 124 for cannabis and 218 for marijuana in the Apple App Store, and 250 each for cannabis and marijuana on Google Play. The top 20 apps in each category in each store were coded for 59 independent apps (30 Apple, 29 Google Play). The three most common content areas were cannabis strain classification (33.9%), facts about cannabis (20.3%), and games (20.3%). In the Apple App Store, most apps were free (77%), all were rated ª17+º years, and the average user rating was 3.9/5 stars. The most popular apps provided cannabis strain classifications (50%), dispensary information (27%), or general facts about cannabis (27%). Only one app (3%) provided information or resources related to cannabis abuse, addiction, or treatment. On Google Play, most apps were free (93%), rated ªhigh maturityº (79%), and the average user rating was 4.1/5. The most popular app types offered games (28%), phone utilities (eg, wallpaper, clock; 21%) and cannabis food recipes (21%); no apps addressed abuse, addiction, or treatment. Conclusions: Cannabis apps are generally free and highly rated. Apps were most often informational (facts, strain classification), or recreational (games), likely reflecting and influencing the growing acceptance of cannabis for medical and recreational purposes. Apps addressing addiction or cessation were underrepresented in the most popular cannabis mobile apps. Differences among apps for Apple and Android platforms likely reflect differences in the population of users, developer choice, and platform regulations. (JMIR mHealth uHealth 2015;3(3):e81) doi: 10.2196/mhealth.4405 KEYWORDS cell phones; mobile apps; cannabis http://mhealth.jmir.org/2015/3/e81/ JMIR mHealth uHealth 2015 | vol. 3 | iss. 3 | e81 | p. 1 (page number not for citation purposes) XSL·FO RenderX JMIR MHEALTH AND UHEALTH Ramo et al recommended guidelines. There has not been a content analysis Introduction of mobile apps related to cannabis use, and it is unclear whether Cannabis is the most widely used illicit substance in the United available apps address addiction or cessation at all. States, with 19.8 million US residents (7.5%) age 12 or older Other content analyses have evaluated the scientific rigor of reporting past-month use in 2013 [1]. In 2012, the prevalence health-related mobile apps. Cowan et al [13] found that iPhone of cannabis use surpassed that of cigarette smoking among youth apps targeting physical activity were generally lacking in age 12 to 17, and this continued into 2013 and 2014 [1,2]. theoretical content, and higher-priced apps and those that Cannabis use and its legalization are contested issues, as policy addressed a broader activity spectrum incorporated more changes have led to increases in the availability of cannabis for theoretical content. In an evaluation of iPhone diet apps, West medical and recreational use in the United States, and problems et al [14] found most apps to be theory deficient and provide associated with using cannabis (eg, diagnoses of cannabis use only general information or assistance. Breton and colleagues disorder) [3]. Cannabis remains a Schedule I substance under similarly concluded that only a small fraction (15%) of apps US federal law; however, two US states have legalized retail for weight control adhered to 5 or more of 13 practices cannabis, two additional states and the District of Columbia recommended by government agencies for the control of weight have passed legislation to legalize use, and 33 states and Guam [15]. Content analysis of apps for pediatric obesity prevention have legalized medical cannabis use. These state-level policy (weight loss, healthy eating, physical activity) found that most changes in the United States and the continued tension between apps (62%) lacked any expert recommendations, and those that federal and state laws have led to a proliferation of did were limited in the number of recommendations made (mean cannabis-related information in the United States and across 3.6, SD 2.7 out of 15 defined guidelines). More than half (56%) the world. of the apps were games, consistent with strategies appealing to Mobile technology, including the mobile phone, has been a young people [16]. Other reviews showed a similar lack of vehicle for cannabis-related news and information. With a global comprehensive, scientific information for asthma management audience totaling up to 1.75 billion in 2014, mobile phone [17], and variance in adherence to established guidelines for technology is pervasive and widely used [4]. Mobile phones first aid by source [18] and for cancer information by target have revolutionized mobile communication technology through audience (health care professionals vs the public) [19]. Results the availability of Internet access. Mobile phones also allow of these studies highlight that, although the material is vast, users to download apps, which are programs designed there is a lack of information with scientific grounding or specifically for mobile phone operating systems. In June 2014, theory-based interventions available to users. Apple announced that 75 billion apps had been downloaded A report of young adults' perspectives on apps for health from its App Store for the iPhone/iPad [5], and a June 2014 behavior change showed that young adults have an interest in report showed that downloads from Google Play for Android using such apps, and that accuracy, legitimacy, security, effort devices had reached roughly 80 billion [6]. Market research required, and immediate effects on mood were important firms have estimated that in 2015, there will be nearly 3 billion influences on app usage [20]. It is unclear whether mobile apps devices running the Android operating system and 500 million for cannabis use address health behavior change in any way. running the Apple operating system (iOS) worldwide [6]. Given widespread cannabis use, political controversy People are increasingly turning to mobile phones to get surrounding its legalization, and the potential for mobile information about potential health risk behaviors such as technology to deliver information about cannabis to a large cannabis use. A majority of users (52% of Americans) use their body of users worldwide, there is a need to understand the nature mobile phones to gather health-related information [7]. of available cannabis information on mobile phones. This study However, it is unclear what is available to them when they do analyzed the top cannabis-related mobile apps on Apple's App seek out this information. Store and Google Play in terms of app characteristics (price, rating, download range) and content codes (strain classification, Some previous work has characterized the content of mobile laws, games, social media, medicinal use, etc). Findings will apps related to substance use. A review of 384 alcohol-related inform how cannabis is portrayed in the context of mobile apps, apps available on Apple's App Store and Google Play found describe what (if any) health information is conveyed in that the majority of apps were primarily for entertainment (50%) cannabis apps, and highlight gaps in available information. or claimed to provide a blood alcohol concentration (39%), and the latter apps were highly unreliable. Only 11% of apps Methods supported the safety of reduction/cessation of drinking [8]. A review of 87 addiction apps on Google Play in 2012 found that Identifying Cannabis Apps apps typically provided information on recovery, content to We used several strategies to identify apps that would be most enhance motivation and promote social support, and tools to likely encountered by users seeking cannabis-related monitor progress [9]. Abroms and colleagues conducted two information. First, a search for the most commonly used words reviews of mobile apps for tobacco cessation, and concluded for ªcannabisº was performed at the website that these apps generally do not adhere to US Clinical Practice UrbanDictionary.com in January 2014. A total of 110 commonly Guidelines for smoking cessation [10,11]. Jacobs and colleagues used and slang terms were listed, and used as search terms on [12] classified Facebook apps for smoking cessation, similarly Apple's App Store and Google Play. At the time of searching, concluding that the few available apps had low adherence to Google Play reported up to 250 apps for each term and all terms http://mhealth.jmir.org/2015/3/e81/ JMIR mHealth uHealth 2015 | vol. 3 | iss. 3 | e81 | p. 2 (page number not for citation purposes) XSL·FO RenderX JMIR MHEALTH AND UHEALTH Ramo et al had 250 results.
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